To the Editor: Cluster headache is the most severe form of primary headache.1 Positron-emission tomography has shown activation of the homolateral posterior inferior hypothalamic gray matter during attacks of cluster headaches, a finding that is apparently specific to the condition,2,3 and voxel-based morphometric magnetic resonance imaging (MRI) has documented alteration of the same area,4 suggesting that cluster headache may be initiated in this area. We reasoned that stereotactic stimulation of this area might prevent activation and relieve intractable forms of cluster headache. We report on a 39-year-old, right-handed man who had excruciatingly painful daily cluster headaches for five years. . . .
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